Self-harm (I am going to call it Nonsuicidal Self-Injury, NSSI) is a foreign concept to many parents and it can be very scary to discover. Historically NSSI was never as transparent as it is today. If you look, you will find young people (and now not so young) who have scars up and down their arms and legs. Please be aware that cutting is not the only type of NSSI. There are many other ways that people harm themselves, but cutting seems to be the second most common (in my practice). First, of course, is chemical use. I will blog about that later. So why does Nonsuicidal Self-Injury happen and what does it mean?
I have seen three main reasons for NSSI/cutting:
1. Teens want to feel more. They feel numb and want to feel something. Anything.
2. Teens want to feel less emotional pain. They engage in NSSI in order to feel physical pain, which they use to temporarily replace emotional pain. Physical pain is easier to tolerate than emotional pain for this teenager.
3. Teens are afraid to speak up about their needs, and use NSSI as a way to communicate anger/sadness (as well as pain/lonliness/loss, etc.) to specific people. Please do not interpret this as: Teens are cutting for attention. This is not what I am saying. I am saying that if your teen is cutting for this reason, please understand that they are using NSSI as a way to communicate.
There are other reasons that teens/people cut themselves, but these are the most common reasons I have seen in my practice. Please note: NSSI is *almost always* NOT a suicide attempt. Generally people who are injuring themselves do not have any intention to die. That being said, people DO die by self-harm. It is usually an accident; a cut that went too deep/in the wrong place. NSSI must be taken seriously, but the best response is generally not to call an ambulance and have your teen taken to the hospital (unless they are badly injured, of course).
What should you (as a parent/guardian) do?
1. Try to talk with your teen. See if they will talk with you about why they are hurting themselves. Express to them that you love them and that you are very scared and worried about what is going on.
2. Ask them what they need. They may not know, but they might surprise you. Be careful with this one. (Begin my rant): If your teen is self-harming because they did not get what they asked you for (i.e.: a new pair of jeans) and then you ask them what they need and they say, “That pair of jeans,” this is a different situation altogether. Do not get the jeans in this instance. I urge you to meet with a counselor in order to work with your teen on limit setting and coping skills for your teen. (End my rant). If your teen expresses that they need to talk with someone, that they hate themselves, that they don’t feel anything, that they feel too much, I urge you to find a counselor for your teen. If they need something that is impossible, “I need you and dad to be back together again,” they are hurting themselves because they do not know how to manage their intense emotional pain.
3. Do not punish your teen for NSSI. NSSI (though it often results in temporary relief for your teen) is a form of self-punishment. Additional consequences tend to make things worse.
4. Find a therapist for your teen. Your teen needs professional help and they need some skills they don’t have. They need a place to go where they can be honest and open about how they feel about themselves and who they are in the world. For starters, you can read my blog about how to find a good therapist for your teen.
5. I don’t want to sound too negative in this blog, but your teen needs help. Do not laugh off this behavior or get angry and tell your teen that they are cutting for attention. Teens die every day by accidently slicing an artery. Teens feel alone when they cut, and they are trying to tell you that they need something more. A good therapist will be able to figure out what that is.
What else do you want to know about how to help your teen decrease and stop NSSI?
Blog written by Sentier therapist Megan Sigmon-Olsen, M.S.W., LICSW
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